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]FOCITy VALIDATION] <br /> ReceiVed By:' (-3.. C~ [ <br /> zoning v alidation."-~-~/ <br /> Date: ~] <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am-4:30pm Phone $8~-$147~ <br /> 24 hr. II~peefion Line S88o791~4~ ' <br /> BUILDING PERMIT APPLI~['IO~5 <br /> <br />FOR CITY USE ONLY <br /> <br />1. JOB DESCRIPTION <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />Mobile Home ~k SD~ ~ <br />~tWidm ~ ~tD~n ~ Ac.s ~ ~g.~t ~ ~m~ Co~u~WelI () Ci~ () <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> I am the PROPERTY OWNER and own, reside in, or will reside in the completed structure and will be my own g*neral contractor. 1 understand that I must register as a construction <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />o. ~qu~.~ foo~ of ~roj~t) vain~iou: $ (at~/5.°c <br /> <br />(1) Additional Plan Reviews or Addendums <br /> <br />(2) Investigation Fee <br /> <br />{3) Reinspection Fee @ $25.00 <br /> <br />(4) Other Inspections not tisted above <br /> <br /> TOTAL <br /> <br />I hexeby certify that the above information is correct. <br />Permits are non-transfexrable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. <br /> <br />MC 15-73 Rev 1195 <br /> <br /> <br />